Hematoma: Red & Purple Spots – Causes, Evolution & Care

A hematoma is a localized collection of blood outside blood vessels, usually from trauma. The overlying skin shows characteristic color changes as hemoglobin breaks down.

Color Timeline

• 0–2 days: Red/purple (oxy/deoxyhemoglobin).
• 2–5 days: Blue/black.
• 5–7 days: Green (biliverdin).
• 7–10 days: Yellow/brown (bilirubin).
• 10–14+ days: Fades to normal.

When to Seek Care

• Large, expanding, or painful hematoma.
• Over joint, near eye, on scalp (especially if on anticoagulants).
• Signs of compartment syndrome (tightness, paresthesia, pallor, pulselessness, pain on passive stretch).
• Neurologic deficit.

Management

• RICE (Rest, Ice, Compression, Elevation) initially.
• Warm compresses after 48h to promote resorption.
• Avoid NSAIDs early if bleeding risk; acetaminophen for pain.
• Surgical drainage if tense, infected, or compressing structures.